• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.1 no.1
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• pp.65-74
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• 1995

There is no line of demarcation between the shoulder and elbow regions. Pain In the arm may originate at the shoulder with reference downwards or less often at the elbow with reference upwards. Most pains indicated by the patient at the elbow or forearm have a local origin, since at the more distal part of the upper limb the capacity for correct localization is good. Once it is clear that the elbow region is at fault, the joint and the muscles about it are tested by ten movements. 1. Four. Passive extension, flexion, pronation, supination-full range, LOM, painful, painless. 2. Four. Resisted extension, flexion, pronation, supination-strong, weak, painful, painless. 3. Two. Resisted flexion, extension at the wrist-painful, painless. The muscles that perform theses two movements arise from the humeral epicondyles and a lesion in either often causes pain felt at the elbow although the tissuse affected is not functionally a part of the elbow (i. e. Tennis elbow and Golfer's elbow).

• Archives of Reconstructive Microsurgery
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• v.7 no.1
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• pp.35-40
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• 1998

The incidence of brachial plexus injury is increasing because of the development of motor vehicle but the the results of treatment was reported poor due to its complex anatomical structure and changes of function and sensory during the recovery after trauma. But the results of treatment has been improved by the recently introduced high sensitive diagnostic method that can evaluate accurately the site and extent of the injury and treatment method. Restoration of the elbow flexion is the most important goal of treatment after brachial plexus injury and nerve graft, neurotization and muscle transfer were used for methods of treatment. From December 1992 to May 1994, the author performed 6 cases of latissimus dorsi transfer at the same side for the improvement of elbow flexion in the patients of brachial plexus injury. There were 5 cases of male, one case of female and average age was 22 years old. The causes of injury were traffic accident in 3 cases, gun shot injury, falldown and birth injury in each one case and in all cases, the type of injury were upper arm type. The average follow up period were 1 year 5 months ranging from 12 months to 4 years 5 months. In all cases, active elbow flexion was impossible before operation and average muscle power was grade I. We analysed the active range of motion, muscle power and the functional results. At the last follow up, range of active elbow flexion was average $124^{\circ}$ and flexion contracture was average 11 degrees and the average of muscle power was grade IV. In the functional analysis, there were two cases of excellent, three cases of good and 1 case of fair. There was no complications including wound infection, vascular compromise and donor site problem. The results of latissimus dorsi transfer for improvement elbow flexion in the patients of brachial plexus injury is one of the useful mettled for the restoration of elbow flexion.

• Clinics in Shoulder and Elbow
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• v.1 no.2
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• pp.242-249
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• 1998

Stiffness of the elbow joint is relatively common after trauma, ectopic ossification, bum, postoperative scar, and etc. Mild flexion deformity can be reduced by use of active or passive motion exercise, dynamic sling, hinged distractor device, or turnbuckle orthosis. But these methods have disadvantages of difficulty in gaining acceptable range of motion only with stretching exercise, re-contracture after conservative managements and poor results that flexion contracture remained. The common described operative exposures for treatment of the stiff elbow are anterior, lateral, posterior, and medial approach. Through Anterior, lateral and medial approach each has not access to all compartments of the elbow. But, posterior approach has benefits that access to posterior, medial and lateral aspects of the elbow and as needed, fenestration to the olecranon fossa that produces a communication between the anterior and posterior compartments of the elbow are possible. From June 1991 through April 1997, 11 patients who had posttraumatic stiff elbow, were treated with debridement arthroplasty through the posterior approach. The purpose of this study are to introduce technique of the debridement arthroplasty and to evaluate final outcomes. With regarding to preoperative pain degree, mild degree matches to 3 cases, moderate to 3 cases, and severe to 2 cases. In preoperative motion, flexion was average 85° and extension was 30°. Postoperatively nine patients had got the complete relief of pain and two patients continued to have mild pain intermittentely. Postoperative flexion improved to 127° and extension to 2°, so that elbow flexion had improved by an average of 42° and elbow extension by 28°. On the objective scale all patients had good or excellent results and they all felt that they were improved by operation. Debridement arthroplasty is one of excellent procedures for the intractable stiff elbow if it is not unstable or it has not incongrous. But it need a meticulous operative technique and a well-programmed rehabilitation.

• Journal of the Korean Society of Physical Medicine
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• v.13 no.2
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• pp.109-114
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• 2018

PURPOSE: The purpose of this study conducted the experiment to check change of ability to grip depending on normal male adult's elbow flexion angle and the effect of kinesiology tape application. METHODS: Normal male adults who studies in H university where located in Kyoungbook state and did not have any factors like fracture, osteoarthritis, deformities and non-neurologic issue which might influence the result of this study were selected as subjects. Elbow of subjects were applied by 5cm wideness kinesiology tape and elbow's angle was selected by $0^{\circ}$, $45^{\circ}$, $90^{\circ}$, $135^{\circ}$ using Goniometer. The change of ability to grip depending on flexion was measured by an electronic dynamometer before and after taping. RESULTS: Before and after taping elbow joint, both ability to grip decrease in more flexion angle and $135^{\circ}$ of elbow flexion was lowest value, 299.84N. Using kinesiology tape, neutral position $0^{\circ}$ was the highest value, 352.26N. The lowest was 331.68N on $135^{\circ}$. According to verifying the change of ability to grip depending on elbow flexion and the change of ability to grip after taping with paired t-test, the result was p<.05, there was significant difference. CONCLUSION: Using electronic dynamometer and estimating the ability to grip after and before kinesiology tape, the ability to grip decrease in more elbow flexion. The ability to grip after using kinesiology tape was relatively higher than before taping.

• Clinics in Shoulder and Elbow
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• v.16 no.2
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• pp.100-106
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• 2013

Purpose: The purpose of this study is to evaluate the relationship between trochlear medial facet osteophyte (TMFO) and elbow flexion in the elbow joints without trauma history. Materials and Methods: Twenty five patients, who underwent computed tomography without elbow trauma history, were reviewed. Patients were checked for osteophyte or loose bodies in the coronoid and olecranon sides. The height and length of TMFO were measured. Results: The average elbow flexion contracture was $18.6^{\circ}$, and further flexion was $112.1^{\circ}$. The TMFO height and length was 2.2 mm and 4.7 mm, respectively. The average elbow further flexion was $105.1^{\circ}$ in the coronoid block group (n=14) and $119.1^{\circ}$ (p=0.011) in the coronoid free group (n=11). The relationship between further elbow flexion and TMFO was significant with a partial correlation coefficient of 0.687(p<0.000) in the TMFO length. Conclusion: Elbow joints with longer TMFO length decrease further flexion.

• Clinics in Shoulder and Elbow
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• v.1 no.1
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• pp.72-77
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• 1998

We treated 5 elbows with post-traumatic flexion contractures (mean contracture: 51 degrees) by arthroscopic anterior capsular release and post-operative alternative flexion and extension splint. Each elbow had been resistant to at least six months of conservative therapy. An incongruent ulno-humeral articulation was considered to be a contraindication to this procedure. All patients complained of the residual deformity and some functional deficit. All patients, after failure of non-operative therapy, desired a operative treatment. At follow-up(mean 21.8 months), there was a mean post-operative contracture of 19 degrees, which is within a functional range of motion. So we conclude that arthroscopic capsular release in selected patients is reasonable alternative to open release.

• Korean Journal of Applied Biomechanics
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• v.13 no.3
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• pp.311-325
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• 2003

A relation between the movement range of arms and arising moment has been studied to find out efficient movement range to minimize impact concerning arm landing in sports aerobics. Four male athletes who won top three in national-level sports aerobics competition were chosen for the experiment. They were allowed to jump in between two force platform so that the right hand and the right leg could land onto the front and rear force platform, respectively. The sampling frequency was 200 Hz. The main conclusions based on the analysis of the angle and joint moment parameters of wrist, elbow, and shoulder are as follows: 1. The wrist moment was small when its angle was small, indicating that the dorsi-flexion of the wrist joint offered a positive influence to reduce wrist moment. 2. The elbow angle increased as wrist angle decreased and vice versa. This means that the movement range of the wrist joint affects that of the elbow joint. The darsi-flexion of the wrist is the position to absorb the impact of the elbow effectively rather than to absorb the impact of the wrist itself. The impact is absorbed by the flexion of wrist joint rather than the wrist. 3. The degree of moment transfer of the shoulder joint, having absorbed the impact from the elbow and elbow joint, became dependent on the efficiency of the fore-joints impact absorption.

• Archives of Reconstructive Microsurgery
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• v.14 no.1
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• pp.63-69
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• 2005

Purpose: The purpose of this study was to analyze the clinical results after Steindler flexoplasty. Materials and Methods: We analyzed 6 cases who had nearly normal finger and wrist joint flexion function, but could not flex elbow joint actively because of upper arm type brachial plexus injury. We performed operation during the period from February 1997 to July 2003. There were 5 males and 1 female with mean age of 28 years (range: $19{\sim}51$ years) when Steindler flexoplasty was done. The average follow-up period was 3 years 11 months (range: 12 months${\sim}$7 years 4 months). We assessed active range of motion of elbow joint, muscle power and elbow function by Mayer & Green grade scale at last follow-up. We assessed how much they were favorable for Steindler flexoplasty and had improvement of upper extremity function and correction of deformity. Results: Postoperative, flexion range of elbow joint improved to average $111.7^{\circ}$ (range: $90{\sim}130^{\circ}$). $25.8^{\circ}$ (range: $15{\sim}45^{\circ}$) in flexion contracture and $16.6^{\circ}$ (range: $10{\sim}35^{\circ}$) in pronation contracture were remained. Range of motion of elbow joint improved to average $85.3^{\circ}$ (range: $45{\sim}105^{\circ}$). Flexion power of elbow joint improved to Grade 5 in all cases. Postoperatively on Mayer & Green grade scale, there were excellent in 3 cases(50%), good in 2 cases(33.3%), fair in 1 case(16.7%). On patient's own assessment of functional improvement, there were excellent in 4 cases(66.6%), good in 1 case(16.7%) and fair in 1 case(l6.7%). Conclusion: Steindler flexoplasty can reserve good clinical results with being improved to active flexion of elbow joint in cases who have functional hand and wrist, but paralysis upper arm muscle in brachial plexus injury.

• Journal of International Academy of Physical Therapy Research
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• v.1 no.2
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• pp.113-119
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• 2010

The purpose of this study was to determine the difference of the pinch strength according to testing posture(standing and sitting) and elbow flexion degree($0^{\circ}$, $45^{\circ}$, $90^{\circ}$ and $135^{\circ}$). Forty normal young adults(male: 20, female: 20, mean age: $22.68{\pm}2.91$ years) participated in this study. The methods of this study were categorized as follows: 1) One set of measurement was performed on four elbow flexion degrees($0^{\circ}$, $45^{\circ}$, $90^{\circ}$ and $135^{\circ}$) in two testing postures(standing and sitting) and all subjects were measured for 3 sets testing procedures in every experimental sessions. 2) Pinch strength in various elbow flexion degree was measured after 2 min rest time, and then each test set was repeatedly performed with 5 min rest time to prevent fatigue of muscles involved in the elbow joint. The result was obtained as follow: 1) In standing posture, there was statistically significant difference at $0^{\circ}$ and $45^{\circ}$, $0^{\circ}$ and $90^{\circ}$, $0^{\circ}$ and $135^{\circ}$, $45^{\circ}$ and $90^{\circ}$, $45^{\circ}$ and $135^{\circ}$, $90^{\circ}$ and $135^{\circ}$. 2) In sitting posture, there was statistically significant difference at $0^{\circ}$ and $45^{\circ}$, $0^{\circ}$ and $90^{\circ}$, $0^{\circ}$ and $135^{\circ}$, $45^{\circ}$ and $90^{\circ}$, $45^{\circ}$ and $135^{\circ}$, $90^{\circ}$ and $135^{\circ}$. 3) Statistically, there was no significant difference between standing and sitting posture in same elbow flexion degree, however pinch strength in standing posture was higher than sitting posture.

• PNF and Movement
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• v.19 no.1
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• pp.147-152
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• 2021

Purpose: This study was conducted to investigate the functional differences of the two heads of the biceps brachii by measuring the functions in supination according to pronation by the angle of the flexion of the elbow joint, except for the activities of the elbow flexors. Methods: This study was conducted with 25 healthy men in their 20s. At a glenohumeral-joint 0˚ flexion posture, angles of flexion of the elbow joint of 0˚, 30˚, 60˚, 90˚, and 120˚ were randomly provided, and they were asked to perform supination and pronation with an elastic band. Using an eight-channel surface electromyogram, the muscle activities of the long and short heads of the biceps brachii were measured. The activities of the short and long heads according to the angle were analyzed using a one-way ANOVA, and as a post-test, LSD was employed. Results: The analysis of the impact of the resistance of the elastic band in supination on the differences in the muscle activities in the short and long heads suggests there was a significant difference between 0˚ and 30˚ (p < 0.05). Conclusion: In supination according to forearm pronation, the long head had greater action in the early flexion posture of the elbow joint, and it is judged that the ratio of the flexion of the elbow joint according to the actions of the biceps brachii was considered small.